Total anorectal reconstruction with artificial bowel sphincter is a good treatment option

Reconstruction with an artificial bowel sphincter is a good option for patients previously treated with an abdominoperineal resection, finds a trial reported in the September issue of Colorectal Disease.

Between 1999 and 2000 the team implanted the ABS in 5 patients (1 male, mean age 51 years) undergoing an abdominoperineal resection.

Of the patients, 3 had been operated on for rectal cancer, 1 for rectal agenesia, and 1 for a giant benign tumor of the pelvis.

Benefits of ABS technique:
- Easier to perform
- More acceptable for patients

Colorectal Disease

The length of follow up ranged from 6 to 22 months.

Manometry assessed a basal pressure, with the ABS cuff inflated between 58 and 62 mmHg.

It was found that all but 1 patient achieved a good grade of continence, with a Wexner score range between 3 and 9.

A certain degree of impaired evacuation occurred in 2 patients. However, with adequate training, this improved and did not affect patient satisfaction.

Dr Giovanni Romano, of the S. Giuseppe Moscati Hospital, Avellino, said on behalf of fellow colleagues, "The ABS is a good option for reconstruction of patients previously treated with an abdominoperineal resection."

"As compared to electrostimulated graciloplasty, the ABS technique seems to be easier to perform and more acceptable for the patients, although the cost of the device is still high," it was concluded.